Removing The Confusion About Nutrition And Popular Diets

It’s that time again, when we feel excited at the prospect of a new year. It’s a chance to “do it right” and reset so you can now accomplish your goals. Inevitably, a lot of those new year’s resolutions are related to health, with a majority of those health-related goals focusing on dieting and losing weight. 

Over the years, I’ve become aware of how much confusion there is around basic nutrition concepts. Unfortunately the food pyramid is nonsense and has created misinformation about what is or isn’t healthy eating. 

Nutrition is one of the core areas I address with every single patient as it has links to practically every health condition. I am convinced that if people understood the basics around nutrition, our rates of chronic diseases would reduce drastically.

While we tend to focus on more specific topics for our articles, I decided Nutrition 101 might be more useful this time of year. I’ll also spend some time highlighting the common diets people follow or start, along with their pros and cons. 

Nutrition Basics

To start, there are three major macronutrient groups: fats, carbohydrates, and proteins. They are called macro-nutrients since we need to consume them in large amounts on a daily basis. 

Each macronutrient has different functions in the body but interestingly, the body can convert one group to another if needed (there are, of course, exceptions to this). 

For example, eating extra carbohydrates? Your body converts them to fat (specifically triglycerides) to store them.

A common misconception about macronutrients is that all calories are created equal. 40 calories from carbohydrates are the same as 40 calories from fats or proteins. 

It is beyond the scope of this article but suffice it to say that carbohydrates are not metabolized in the same way as fats; fats are not metabolized in the same way as proteins; and proteins are not metabolized in the same way as carbohydrates. So the types and amounts of macronutrients you eat, not just calories, can make a big difference in your health.

Also, what you pair foods with can affect their digestion. So eating a donut, which is almost all carbohydrate is very different than eating a balanced meal with salmon, steamed broccoli, and brown rice.

Another fact that can cause confusion is that all foods contain all of the macronutrients. We just categorize them based on what they contain a majority of. For example, chicken, one of America’s favorite proteins, also contains some fat and carbohydrates. And yes, vegetables, which fall under the carbohydrate category since that is the bulk of what they are made of, also contain some fat and protein. 

Proteins

So let’s begin with the least confusing macronutrient: proteins. Proteins are the major building blocks of our body. They are composed of small molecules called amino acids, that string together like a necklace to form a protein. 

Proteins make up our enzymes (enzymes help the body do chemical reactions), some of our hormones (like insulin), form structures (like collagen and muscles), and even assist with transportation of nutrients and wastes (hemoglobin in blood are proteins). As you can see, proteins are vital to our existence.

Of the protein building blocks, there are 20 amino acids, of which 9 are what we call “essential”. Essential amino acids have to be ingested daily in order to have high enough amounts to function. Non-essential amino acids can be converted from other essential or non-essential amino acids so we’re not as concerned if they are lacking in your daily nutrition.

In general, animal foods contain all the essential amino acids. When it comes to plants, only soy and quinoa contain all the essential amino acids. That being said, as long as you’re mixing your plant forms (ie nuts and grains) you should be able to get all the essential amino acids throughout the day without animals. 

Carbohydrates

The next macronutrient that is very misunderstood is carbohydrates. The term carbohydrates itself tends to be confusing as it includes healthier forms like fiber as well as detrimental forms like refined sugars.

As far as functions go, in general, carbohydrates main function is to make energy. Simple carbohydrates like glucose and fructose, are converted into energy (ATP) that the body uses to do pretty much anything and everything. Without ATP, we would cease to function.

Simple carbohydrates also include lactose (milk sugar) and sucrose (table sugar). They are then broken down into smaller components such as fructose or glucose to digest but they lead to the same function of creating energy.

Interesting to note that fructose is not metabolized in the same way as glucose, which is highlighted here. Most of the refined carbohydrates we ingest are either some combination of glucose and fructose.

In order to get glucose into the cells where they can be turned into energy, insulin is released. Insulin is a pro-inflammatory hormone that has it’s own detrimental effects on the body. 

Complex carbohydrates include storage forms of carbohydrates in animals and plants. Since these are more complex as in larger molecules, they take time to digest, if we digest them at all (think fiber). 

For animals, the storage form of carbohydrate is glycogen, which is found in high amount in our liver and muscles. For plants, the main storage form of carbohydrates are starches, found in seeds, roots, and tubers.

Fats

Our final macronutrient, and by far the most misunderstood, is fat. There are several sub-types of fats that each have different and specific functions. 

In general, fats make-up a variety of hormones, help us absorb fat-soluble vitamins and nutrients, store energy, and maintain the membranes of our cells (what is supposed to stay out, stays out and what is supposed to stay in, stays inside the cell). 

They are roughly categorized as fatty acids (think omega 3s), cholesterol, phospholipids, and triglycerides. Each has it’s own functions and importance. 

Important to note, there are essential fatty acids. So just like the essential amino acids, they are fats that have to be eaten every day and are essential to functioning. They cannot be converted or made from other fats or other nutrients. Notice there are no essential carbohydrates.

Obviously there is so much more that could be said about the individual nutrients that is beyond the scope of this brief article. But hopefully that gives a broad enough overview to make sure we’re all on the same page.

Popular Diets

Now that we have a very basic understanding about the major macronutrients, let’s briefly highlight the different diets that are popular. 

Ketogenic Diet

One of the more popular diets right now is the ketogenic (keto for short) diet. The ketogenic diet was formulated over 80 years ago to help treat children with epilepsy. The main premise behind the ketogenic diet is to eat high amounts of fat and limit protein and carbohydrates, which puts the body into ketosis. 

Ketosis is when the body uses fat for energy instead of carbohydrates so essentially, you are burning fat. When you’re in ketosis, ketones are produced which is something that can be measured in blood or urine. Ketosis itself is not harmful. Where things can go wrong is if the levels of ketones build up too high and cause ketoacidosis. This can occur in those with diabetes where the levels of ketones and blood sugar are too high and create a dangerous acidic state in the body. 

Most people today who follow a keto diet are really following a diet that more closely resembles Atkins, which is low carb with higher proteins and fats. It is very common for someone to say they are following a keto diet but not actually measuring ketones in their urine to ensure they are in ketosis.

In addition to treating epilepsy, the keto diet has been shown to help with weight loss and improve blood sugar and insulin levels. However, it comes with a host of downsides including increased occurrence of kidney and gallstones, abnormal liver function, dehydration, bone thinning, increased bleeding, GI issues like constipation or diarrhea, and menstrual irregularities. 

Paleo Diet

Another popular diet is the Paleo diet. This is also known as the Stone Age or Caveman diet. The premise behind the Paleo diet is that we live in a world with an abundance of processed foods, nothing which our ancestors would recognize. To follow a Paleo diet, it involves eliminating processed foods and grains (bye bye breads, cereals, rice, etc) and focusing on high proteins and fibers. 

The Paleo diet has been shown to help with weight loss and blood sugar regulation, just like the keto diet. However, due to the elimination of processed foods, it has also been shown to reduce inflammation as well. 

The downside to following a Paleo diet is that it takes a lot of planning as it requires meal preparation. Another consideration is that since you’re focusing on high protein, which is usually in the form of meat, quality of meat is important. Eating animals that are fed corn or other refined grains can have detrimental impacts on your own health. In addition, too much protein can be hard on your kidneys.

Another thought about the Paleo diet is that the produce that is available to us today is very different than what our ancestors had access to. Due to the development of agricultural practices, we have delicious plants like broccoli and cauliflower that was not available in its current form years ago. This Ted talk goes into this further.

Atkins Diet

The next popular diet that is still around is Atkins. The Atkins diet was developed in the 1970s by Dr. Robert Atkins, a cardiologist. He found a link between high carbohydrates and chronic diseases like heart disease and created a low carbohydrate diet.

The Atkins diet is more involved than just reducing carbohydrates. It involves 4 phases of carbohydrate restriction as well as counting carbohydrate consumption.

When followed according to plan, the Atkins diet has been shown to help reduce weight, blood pressure, and cholesterol, as well as regulate blood sugar issues. 

The downsides to following the Atkins diet is that carb counting can become tedious for people and the phases can be hard to follow. In addition, Atkins does allow processed foods which is abundantly available on their website. 

Intermittent Fasting

Another popular diet is intermittent fasting. Intermittent fasting is just like it sounds, when you fast intermittently. Some choose to fast one day a week or other variations include limiting the hours during which you eat. The most popular iteration of intermittent fasting is avoiding eating for 16 hours and only eating during an 8 hour window. 

Intermittent fasting has been shown to reduce weight as well as improve insulin levels. However, a lot of the studies showing benefits have been done on animals and of the human studies, less on women. 

Since the only rule is the timing of when you eat, intermittent fasting is probably one of the easiest diets to follow. And the idea behind breakfast was to “break the fast” so there is some inherent wisdom to not eating at all hours of the day and night.

However, you could still be following intermittent fasting and eat all the candy, cookies, ice cream, and soda that you’d want, as long as it’s in that window of time. And as mentioned above, a lot of the studies have been done in animals with limited information specifically on how it affects women and hormone-dependent processes like fertility and thyroid conditions. 

Plant-Based Diets

The last type of diet are plant-based diets. While there are multiple iterations of these (vegan, vegetarian, etc) the main premise is to eliminate animal products, mostly meat). 

Plant-based diets have been shown to help with weight loss and lower cholesterol levels. And by limiting your use of animal products, it helps the environment since it takes a lot more resources to produce meat compared to vegetables.

That being said, some people just love meat (or cheese, eggs, etc) and find following a plant-based diet difficult. And candy, chips, and soda would technically be considered plant-based so it very possible to be following a plant-based diet but eating limited amounts of vegetables. Another trap that people can fall into is eating a lot of the fake meat products for protein, but which tend to be soy-based. Consuming soy in moderation is ok but not something you want to eat with every meal.

Whether you choose to follow a diet or not, research has shown the benefits of making small consistent changes over time. So perhaps this year you may consider forgoing the latest fad diet, since none of them are without faults, and instead focus on improving your habits, like meal planning and prepping or doing some kind of physical activity every day, no matter how brief. Small changes over time lead to large improvements in the long run.